Healthcare Goes Local, from State Capitals to Big Box Stores

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Hello Readers, the federal government may be shut down, but The Week That Was team is firing on all cylinders! And it’s a good thing because healthcare is not lacking in the headlines.

• In the battle against the opioid crisis, Walmart is the next big player. The superstore is teaming up with DisposeRx, to create opioid disposal sites at all of its pharmacy locations. DisposeRx makes a powder that, when mixed with water, dissolves prescription medications.

• Walmart isn’t the only retailer making health news this week. Your neighborhood CVS has added rheumatoid arthritis to its repertoire of “condition-specific, highly personalized Transform Care” programs to help clients better manage care and costs. With Transform Care, CVS joins the growing ranks of industry heavy weights who are adding more value-based management strategies and outcomes-based contracts to their care models.

• Kentucky is among the first states to take the Trump Administration up on its Medicaid waiver program pledges and Colorado wants diabetes drug pricing to be more transparent.

There’s a lot more news beyond these retail rivals. We’ve diagnosed it for you in The Week That Was...

►NO JOB, NO COMMUNITY SERVICE, NO MEDICAID?

While talk of healthcare reform has taken a backseat in DC to other policy matters, state policymakers are forging ahead with a variety of new measures designed to control Medicaid costs. One day following the Trump Administration’s public support for Medicaid work requirements, Kentucky became the first state to receive permission to adopt such a policy for non-disabled adult residents. This means that to continue to receive Medicaid benefits, recipients must demonstrate they are working, looking for work, or providing community service or volunteerism. The state is also pursuing premiums for low-income Medicaid recipients, among other changes to the program. Republican Governor Matt Bevin campaigned on a promise to pare back the state’s Medicaid expansion from 2015, which was implemented under a then-Democratic governor. Governor Bevin has threatened to shut down the expansion completely if courts block part of his planned changes.

► OUR TAKE

What does all this mean for Kentuckians? Statistics show that one-third of Kentucky’s population is enrolled in Medicaid, so the policy could have wide-ranging impact on access to healthcare in the state. And, at least 10 other states have filed for CMS waivers to adopt similar requirements. But critics argue that demonstrating such eligibility requirements will cost the state significant funds in administrative burden. Additionally, several third-party groups have vowed to challenge these “waivers” in the courts arguing that they contravene the intent of the Medicaid program.

►ROCKY MOUNTAIN STATE SAYS SHOW ME YOUR PRICING

Moving to the mid-west, a Colorado lawmaker is seeking to pass a bill that would force transparency in the pricing of diabetes drugs. Similar to legislation passed in Nevada in 2017, HB18-1009 (a.k.a. The Diabetes Drug Pricing Transparency Act of 2018), would require diabetes manufacturers to disclose their costs, pricing histories and rebates to pharmacy benefit managers as well as explain price hikes. The state representative who authored the bill states the cost of insulin has risen more than 1,200% in the last 20 years. The industry trade association, PhRMA, says the bill does not address the affordability of medicines and ignores the role middlemen play in impacting diabetes drug costs.

► OUR TAKE

The Colorado legislation follows a number of states trying to take action on healthcare spending by focusing on drug costs, whether by category, like this focus on diabetes, or percentage price increase such as in Vermont or New York. As states continue to push to develop their own strategies to combat healthcare costs, life sciences companies must take heed of how these patchwork policies will impact their operations and reputation. When executed, most of these bills have few “teeth” but the legal and shame factors could be high–at a time when the industry’s reputation is already on “low.” While individual insulin and diabetes drugmakers have sought out individual response strategies, the day may be fast approaching to try something new.

►THE TEXT THAT ALARMED A NATION

Just last weekend, residents of Hawaii received an emergency alert about an incoming ballistic missile that thankfully turned out to be a false alarm—but not before panicking residents and visitors alike. The mishap exposed flaws in the alert system, including the ramifications of a mistake as simple as selecting the wrong option in a scroll-down menu. Perhaps even a bigger issue than the initial mistake was the fact that it took 38 minutes to send out a “false alarm” message, and by that time, social media platforms like Twitter had already started confirming the mistake.

► OUR TAKE

As risk mitigation professionals, this story struck a particular chord with us. We have counseled many clients on the importance of establishing procedures and scenario plans for handling a crisis. Our mantra: Be ready. Because you can’t be building a plan when you must be executing the plan!

If your company or brand faces high risk or high likelihood issues, we suggest establishing a core team responsible for crisis management. This must include a group dedicated to making decisions and separate communicators to carry out those plans. By instilling protocols for how crises must be managed and delineating who is charged with leading, executing and communicating, organizations can avoid issuing misinformation–and act rapidly. As Hawaii reminded us, time matters.

Whether the government is operating or not, we look forward to seeing you next week for another dose of The Week That Was.